Tetany, and foreign bodies in the stomach : tetany caused by a mass in the stomach, composed of forty metallic articles, weighing one pound, gastrotomy, cured / by James P. Warbasse.

  • Warbasse, James Peter, 1866-1957.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Tetany, and foreign bodies in the stomach : tetany caused by a mass in the stomach, composed of forty metallic articles, weighing one pound, gastrotomy, cured / by James P. Warbasse. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    bodies. Articles remained in the stomach until they became disentangled and then passed on. The copper parts of the knives were not bright, but dull in appearance, and there were no gross evidences of the presence of the chloride of copper. Nor did the patient present any symptoms of poisoning from copper salts. His appetite was always good. The symptoms of tetany in this case were not recognized until after the operation, when a history of his recent attacks was obtained, and the facts concerning previous attacks in- quired into. The symptoms described by Trousseau, Chevos- tock, Erb, and Hoffmann were not elicited. This man, as was the case with the patient reported by Dr. Cunningham, had repeatedly fallen in tetanic convulsions, and been in three dif- ferent hospitals, and the disease failed of recognition. The peculiar and dramatic interest attracted by his other condition undoubtedly turned attention from the more important and interesting tetanic feature of the case. The cause of this man’s symptoms cannot be found in pyloric stenosis. What moderate dilatation he had was due to the dragging down by the weight of foreign matter, and to the efforts of the stomach to empty itself of a mass that could not pass through the pylorus. As a matter of fact, a normal pylorus may be the cause of dilatation of the stomach if it is not large enough to accommodate the contents which the stomach is try- ing to extrude. As far as the effect on the stomach wall goes, it amounts to the same thing as stenosis of the pylorus. As to fermentation of food particles among the foreign bodies, it would seem probable that enough of the chlorides of iron and copper would be evolved to inhibit this. It seems to me that this case speaks for the mechanical theory of the etiology of gastric tetany.